Individual provider Active NPI

Judith F Shea, MD

  • Internal Medicine Physician
  • Greenwich, CT
National Provider Identifier
1710974530
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
028512 Issued in CT
Practice address
7 Riversville Rd
Greenwich, CT 06831-3627
Phone
(203) 531-1808
Fax
(203) 531-8326
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 028512 CT Primary
Internal Medicine Physician 207R00000X 1763461 NY

Addresses

Primary practice location

7 Riversville Rd
Greenwich, CT 06831-3627

Mailing address

7 Riversville Rd
Greenwich, CT 06831-3627
Phone (203) 531-1808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120202000134 CT Practitioner - Internal Medicine 6709934102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
JS Weill Medical College, Cornell University, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Glenville Medical Associates P.CGroup PAC ID 1456408400, 7 clinicians

Practice addresses (Care Compare)

7 Riversville Rd
Greenwich, CT 06831-3684
Phone (203) 531-1808

Hospital & facility affiliations

  • Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
028512CTMDInternal Medicine Physician
1763461NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glenville Medical Associates P.C Internal Medicine CurrentSince Oct 31, 1988 Accepting new patients
Greenwich Sports Medicine PC PastSince Nov 19, 2016 Accepting new patients

Locations

7 Riversville Rd
Greenwich, CT 06831
Phone (203) 531-1808

7 Riversville Rd
Ste 1
Greenwich, CT 06831
Phone (203) 531-1808

Interoperability endpoints

  • Direct secure messaging: jshea7490@direct.ynhh.org
  • Direct secure messaging: judith.shea@499728505765892.direct.elationemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1710974530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 RIVERSVILLE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068313627",
            "telephone_number": "203-531-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 RIVERSVILLE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068313627",
            "telephone_number": "203-531-1808",
            "fax_number": "203-531-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "JUDITH",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "028512",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1763461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.